Researchers at Shaare Zedek Medical Center (Jerusalem, Israel) conducted a prospective, self-controlled study of 43 women aged 26 to 44 undergoing IVF treatment. The women identified as poor responders (less than 4 oocytes retrieved) were treated with at least three months of 5-Dehydroepiandrosterone (DHEA) supplementation (75 mg/day). Biochemical parameters recorded before and after DHEA supplementation included serum-cycle day 3 Follicle Stimulating Hormone (FSH), Anti-Müllerian hormone (AMH), Inhibin B, E2, and DHEA. Ultrasound parameters recorded included antral follicle count (AFC) and endometrial thickness. To assess markers for ovarian function at different stages of follicular maturation, very early AMH, early inhibin B, AFC, and the number and quality of oocytes both before and after DHEA supplementation were recorded.

The results showed that following DHEA supplementation, there was a significant increase in antral follicle count, while no significant changes in baseline biochemical parameters were noted. The change in response to IVF treatment was also significant, with an increased peak E2 concentration, the number of follicles over 15 mm on the day of human chorionic gonadotrophin (hCG) administration, and the number of oocyte retrieved, with consequent increase in the number of metaphase II oocytes and the number of embryos. There were 11 clinical pregnancies after DHEA treatment. The study was presented at the 2010 annual conference of AYALA, the Israeli Fertility Association, held during May 2010 in Tel Aviv (Israel).

“DHEA appears to improve IVF treatment outcome, with an increase in the number of oocyte and embryos, and appreciable pregnancy rate,” concluded lead author Jordana Hyman, M.D., director of the Shaare Tzedek IVF clinic, and colleagues. “It seems that the mechanism does not include recruitment of more preantral or very small antral follicles, but rather rescue from atresia of small antral follicles (increased AFC).”

DHEA is an endogenous steroid that has been implicated in a broad range of biological effects in humans and other mammals. DHEA is produced by the adrenal glands, gonads, and the brain. It acts on the androgen receptor both directly and through its metabolites, which include androstenediol and androstenedione, which can undergo further conversion to produce the androgen testosterone and the estrogens estrone and estradiol.

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